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Here is a list of all the forms, applications, and manuals related to Workers' Compensation Insurance in the state of Arkansas. We strive to keep this up to date and accurate.
As with all information we provide please verify the accuracy of this information with the Arkansas Workers' Compensation Commission.
If you have any questions about where to find or how to fill out one of these forms, please feel free to call one of our Workers' Compensation Experts at 888-611-7467.
AR Acord 130 Workers' Compensation Application.
The standard Acord 130 application form for workers' comp coverage in Arkansas.
Arkansas First Report of Injury Form
AR First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
Employee's Notice of Injury and Stockholders
This notice should be filed by the employee to the employer. It also contains the Employer Notice to the Employee.
Arkansas Claim for Compensation
Complete this form to file a claim for workers' compensation for injuries.
Facts for Injured Workers In Arkansas
Information about workers' compensation in Arkansas for workers and employers.
Application for Voluntary Drug-Free Workplace Program
Complete this application to meet compliance with the Voluntary Drug-Free Workplace Program.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers' compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
Improve your business cash flow with our Agency Pay As You Go Workers' Comp plans. Available through most of our insurance companies.
State Resources for AR
Arkansas Insurance Department
1200 W. Third StreetLittle Rock, AR 77201800-282-9134 Arkansas Commission
Arkansas Workers' Compensation Commission
PO Box 950Little Rock, Arkansas 72203-0950800-622-4472 http://www.awcc.state.ar.us/
Workers' compensation insurance is required by law for Arkansas employers.
Arkansas forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form your need for Arkansas.
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